NPI | 1851664320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T1651) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203522) |
Enumeration Date | 2012-02-14 |
Last Update Date | 2023-06-20 |